Menorrhagia (also termed hypermenorrhea) is a thorny concern among adolescent girls of reproductive age. Often these subjects, without any inherited or acquired coagulation disorder, reported heavy menstrual bleeding that has interfered with their lives. In this regard, alternative medical treatments as prostaglandins synthetase inhibitors (nonsteroidal antinflammatory drugs) or hormones (oral contraceptives) as well as antifibrinolytic compounds (tranexamic acid) are frequently prescribed. Nevertheless, these therapies limit clearly long-term use. Wide experience has recently demonstrated that the subcutaneous infusion of the synthetic analogue desmopressin is an effective treatment for menorrhagia in women with von Willebrand disease (vWD). On this basis we treated eleven girls (age 11-14 yrs), without any congenital or acquired bleeding disorder, with the subcutaneous injection of concentrated desmopressin (EMOSINT, SCLAVO, Siena) in 1 ml vial (20 μg) at the dosage of 0.3 μg/kg on home self-administration for hypermenorrhagic episodes (n=22) and menorrhagia (n=5) at the onset of the puberty. Basal plasma prothrombin time, activated thromboplastin time, fibrinogen and thrombin time were in normal range. Bleeding time (Ivy method), platelet count, ristocetin-induced platelet aggregation and platelet adhesiveness «in vitro» were in average normal average. Lupus anticoagulant was negative. All girls were required to selfevaluate menorrhagia recording the number of pads used and days of the menstruation. From our study mild face flushing, with or without headache, was referred from 50% of subjects. No other side-effects were reported and patient's compliance was good. According to all girls, in 90% of cases the clinical response to desmopressin was scored as effective (15%) or very effective (75%). The reduction in pad consumption was remarkable in 25 treated menstrual bleedings. As expected, factor VIII-complex related activities, assayed in two cases during in-hospital, after subcutaneous desmopressin treatment were increased. These data would suggest that subcutaneous desmopressin is an effective treatment for menorrhagia and also a viable option for the hypermenorrhea occurring at the onset of the puberty. In our opinion, towards medical therapies offered to youngest women with menorrhagia, the present stepwise approach may be reasonable from quality of life considerations and subject's preferences.